Index Case (used with patient’s permission)

by Christina Perron

Abstract: Non-suicidal self-injury is thought of as a disordered emotional coping mechanism. This phenomenon is gaining increasing attention in the psychiatric and lay literature as it often is a harbinger of significant ongoing life stressors, a marker of adverse childhood experiences, and/or a manifestation of psychiatric disease. Dermatologists investigate and treat diseases of the skin and are therefore often privy to a patient’s closely guarded stigmata of self-harm. A fourth-year medical student questioned how best to care for this patient population in the outpatient dermatology clinic. A review of the current dermatologic literature proved largely silent on this subject. A dermatology clinic visit may represent an ideal, and under-utilized, opportunity to monitor patients for evidence of self-injurious behaviors and to make note of patients’ self-harming thoughts and actions. We suggest dermatologists be prepared to reinforce ongoing behavioral techniques and therapeutic treatment, as well as to identify escalating behaviors and to make appropriate referrals.

Christina Perron is a fourth-year medical student at the University of New England College of Osteopathic Medicine, Class of 2013.  Email: cperron@une.edu

Keywords: NSSI, non-suicidal self-injury, sexual abuse, culture bound syndrome, cutting, self harm, dermatology, excoriating, A.C.E., borderline personality, adverse childhood experiences. dermatitis artefacta,

Full Text: Observatons on Cutting  PDF: Observatons on Cutting